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Radical hysterectomy. A. Exposure of the inferior epigastric vessels before transection of the rectus muscles. B. Ligation of the inferior epigastric vessels before transection of the rectus muscles. C. Ligation and division of the round ligaments opens the pelvic retroperitoneum. D. First peritoneal incision lateral to the ovarian vessels and across the vesicouterine fold. E. Narrow malleable retractors (Indiana retractors) are placed into the paravesical and pararectal spaces to provide excellent access to the lateral pelvic sidewall and pelvic lymph nodes. F. Pelvic lymphadenectomy (external and internal iliac vessels). G. Pelvic lymphadenectomy (obturator fossa). H. Development of the uterine and superior vesical arteries. I. The uterine artery has been clipped and divided near its origin. J. The proper ovarian ligament and proximal fallopian tube are clamped and divided if the ovary is to be preserved. K. The Source: Gynecology, Schwartz's Principles of Surgery, 10e ureters have been detached from the posterior peritoneum of the broad ligament and are retracted laterally. The rectovaginal space is developed using Citation: Brunicardi F, Andersen Billiar TR, Dunn DL,M.Hunter JG,are Matthews Pollock RE. Schwartz's of Surgery, blunt finger dissection. L. Transection of the DK, uterosacral ligaments. Clamps placed JB, on the lateral vagina, takingPrinciples care to remove 3 to 10e; 4 cm2014 of the Available at: http://mhmedical.com/ Accessed: May 06, 2017 upper vagina. Copyright © 2017 McGraw-Hill Education. All rights reserved